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目的探讨儿茶酚氧位甲基转移酶(catechol-O-methyltransferase,COMT)基因Val158Met多态性与抑郁症发病风险及抗抑郁药物疗效的遗传相关性。方法计算机检索Medline、Embase、Web of Science和Cochrane Library,检索时间范围从建库至2014年3月1日,收集COMT基因Val158Met多态性与抑郁症相关性的病例对照研究,以及与抗抑郁药物疗效相关性的遗传药理学研究。采用Stata 12.0软件进行meta分析,合并效应值及其95%CI并对结果进行异质性检验和纳入文献发表偏倚进行评估。结果 COMT纯合子Met/Met或Val/Val基因型为抑郁症的保护因素(OR=0.82,95%CL:0.75-0.91);在抑郁症患者中,COMT纯合子Met/Met或Val/Val基因型携带者对抗抑郁症药物的治疗反应较差(反应—无反应组:OR=0.73,95%CL:0.56-0.96;缓解—无缓解组:OR=0.65,95%CL:0.48-0.66)。结论 COMT基因Val158Met多态性与抑郁症及抗抑郁药物临床疗效存在显著的遗传关联性。
Objective To investigate the genetic association between Val158Met polymorphism of catechol-O-methyltransferase (COMT) gene and the risk of depression and the efficacy of antidepressant drugs. Methods A computer-assisted online search of Medline, Embase, Web of Science and Cochrane Library was performed to search case-control studies on the association between the Val158Met polymorphism of COMT gene and depression in our database from 1 July 2014 to the 1st of March 2014, Pharmacogenetics of efficacy-related studies. Stata 12.0 software was used for meta-analysis, the combined effect value and its 95% CI were combined and the results were heterogeneously tested and included in the publication bias. Results The COMT homozygote Met / Met or Val / Val genotypes were the protective factors of depression (OR = 0.82, 95% CL: 0.75-0.91). In the depression patients, the COMT homozygote Met / Met or Val / Val gene Type 2 carriers responded less well to the treatment of depression (Response-no response: OR = 0.73, 95% CL: 0.56-0.96; Relief-no remission: OR = 0.65, 95% CL: 0.48-0.66). Conclusion The Val158Met polymorphism of COMT gene is significantly associated with the clinical efficacy of depression and antidepressant drugs.